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目的探讨60岁以上梗阻性结直肠癌的临床特点及诊治原则。方法回顾性分析56例60岁以上结直肠癌并发肠梗阻患者的临床资料。结果右半结肠癌并发肠梗阻18例,采用右半结肠一期切除吻合治疗17例;右半结肠切除,回肠末端造口术1例。左半结肠直肠癌并发肠梗阻38例,左半结肠、直肠一期切除吻合10例;肿瘤切除,近端造口,远端封闭25例;肿瘤近端肠管永久性造口术3例。术后出现并发症12例19例次,死亡2例。结论 对于60岁以上梗阻性结直肠肿瘤,手术方式取决于其身体条件,应重视合并疾病的处理,合理选择手术方式,是降低术后并发症和病死率的关键。
Objective To investigate the clinical features and diagnosis and treatment of obstructive colorectal cancer over 60 years old. Methods The clinical data of 56 patients with colorectal cancer over 60 years of age with intestinal obstruction were retrospectively analyzed. Results Right colon cancer with intestinal obstruction in 18 cases, using the right colon resection and anastomosis in 17 cases; right colon resection, 1 case of distal ileostomy. Left colon and rectum colon obstruction in 38 cases, left colon, rectal anastomosis in 10 cases; tumor resection, proximal stoma, distal closure in 25 cases; 3 cases of proximal tumor bowel permanent ostomy. Postoperative complications occurred in 12 cases of 19 cases, 2 patients died. Conclusion For patients with obstructive colorectal cancer over the age of 60, the surgical method depends on their physical condition, and should pay attention to the treatment of combined diseases. The rational choice of surgical methods is the key to reduce postoperative complications and mortality.